BACKGROUND: Over the years, breast cancer surgery has undergone tremendous advances. The previous norm of maximal operative intervention has now shifted toward minimally necessary surgery. Sentinel lymph node biopsy (SLNB) is a technique with the potential to avoid axillary dissection and its associated complications in clinically node-negative breast cancer.

METHODS: A collaborative multidisciplinary breast cancer management team was established at our institution. Methylene blue dye was injected at intratumoral and peritumoral locations. Sentinel lymph nodes were mapped and harvested in 40 patients. The nodes were sent for frozen section analysis, and based on the pathology results, we either avoided or proceeded with axillary dissection.

RESULTS: We performed 40 SLNB procedures over a period of two years. Sentinel nodes were successfully identified in all cases. In 32 (80%) of the patients, SLNB results were negative, allowing us to avoid axillary dissection in this group. For the remaining patients, axillary dissection was performed.

CONCLUSION: Our initial experience at St. Paul’s demonstrates that SLNB is both feasible and effective in resource-limited tertiary settings in developing countries. This procedure represents a preferred alternative to routine axillary dissection.

KEYWORDS: Breast Cancer, Sentinel lymph node, Sentinel lymph node biopsy, axillary dissection